More midwives at Bedford and Luton & Dunstable hospitals since damning CQC report

Immediate action was taken after the unannounced visits from the Care Quality Commission (CQC) to Bedfordshire Hospitals NHS Foundation Trust’s maternity units in November 2023, according to a report to Central Bedfordshire Council’s social care, health and housing overview and scrutiny committee.

Although both units were downgraded, the CQC noted outcomes for mothers and their babies at Bedford Hospital maternity unit and Luton and Dunstable’s unit remain good, said the report.

“At Luton, the CQC found that staff were responsive and worked hard, with limited resources, while at Bedford staff provided good care and treatment.

“The service still doesn’t meet the 90 per cent fill rate as consistently as we’d like, most recently because of high levels of maternity leave and long-term sickness.

“Since the time of the report, the registered midwifery vacancy has decreased from 38 per cent to 1.8 per cent at Bedford Hospital. At the Luton and Dunstable, the registered midwife vacancy is 7.06 per cent.

“The trust has secured the planned recruitment of further newly qualified midwives for quarter four on registration, which will further reduce the vacancy gap.

“Focused work has been undertaken to ensure internationally educated midwifery colleagues have appropriate support on arrival and through their induction. A monthly external maternity assurance board is in place.”

Bedfordshire Hospitals NHS Foundation Trust chief executive David Carter said: “We were particularly disappointed by the report’s conclusion in Bedford because we were confident we’d made significant improvements and sustained those.

“In Luton, we’ve seen a more challenged picture. We’ve seen a rise in births for 2023/24 with 5,500, up from 5,200. The other issue is staffing as we lost some of our more experienced midwives during the pandemic.

“It was the one service that had to continue. It’s that dual impact of a rise in the complexity and a less experienced workforce which has created the circumstances or challenges we face.

“The really positive news is the transfer of both maternity and neonatal to the new Luton and Dunstable building later this year.”

Bedfordshire Hospitals Foundation Trust chief nurse Liz Lees explained: “In 2023, we had a significant midwifery vacancy, particularly in Luton.

“A number of experienced midwives decided to leave or retire. Around that time we’d recruited 60 midwives from different countries overseas, working in different care models across the globe.

“We underestimated the preparation we should have done with our teams, which created some of the cultural challenges where there were some issues around behaviour in the department.

“Those midwives are much more settled into our service now. Some have moved into senior roles, which is really encouraging. We’ve quite a healthy pipeline of midwives coming out of the University of Bedfordshire and our vacancy rate is in a much better place than two years ago.”

The committee agreed to highlights the inconsistency of the ratings process and the constrained NHS financial circumstances for achieving every objective expected. It asked the trust executive to establish what extra support can be offered to maternity staff.